Information Collection

Form X-17A-5 Part II

IC 258556 under ICR 202302-3235-005 · OMB 3235-0498.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3235-0498 can be found here:

Documents and Forms

Document Name Document Type
Form X-17A-5 Part II Form X-17A-5 Part II Form
X-17A-5 Part II X-17A-5 Part II FOCUS Report Part II (as proposed to be revised).pdf Form
X-17A-5 Part II X-17A-5 Part II FOCUS Report Part II (as proposed to be revised).pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form X-17A-5 Part II	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 17 CFR 240.17a-12

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	X-17A-5 Part II	X-17A-5 Part II	FOCUS Report Part II (as proposed to be revised).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.